Is Dental Insurance Worth It?PolicyScout’s guide to dental insurance, what it covers, and whether it's worth getting.
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According to the Centers for Disease Control and Prevention (CDC), approximately 50.2% of adults in America, aged 18–64 with private health insurance, had dental care coverage in the past 12 months.
However, many still ask the question: is dental insurance actually worth it?
In this article, we discuss what dental insurance is, what it offers and covers, how much it costs, and if it's worth getting.
What Is Dental Insurance?
A dental insurance plan is a policy that provides coverage for basic dental services, offered by insurance providers and dentists.
Let’s break down how individual dental insurance works. You select a plan based on:
The providers (dentists) who you want to be able to visit
What you can afford to pay
If you already have a dentist you like and they are in the insurance company’s network, you’ll be able to opt for one of the less expensive plans.
If you don’t have a dentist at all, you can choose from any of the dentists who are in the network and again have the option of a less expensive plan.
However, if your existing dentist is not in the network, you can still get insurance, but you’ll pay significantly more to see your out-of-network provider. The cost might be so much higher that it would be cheaper not to be insured.
Your monthly premiums will depend on:
The insurance company
The plan that you choose
According to the Kaiser Family Foundation, Americans on average pay about $360 a year, or between $15 and $50 a month, for dental insurance. This means that you might be spending between $180 and $600 on dental costs each year even if you don’t get any work done.
What Does Dental Insurance Cover?
Dental insurance typically provides coverage for:
Two yearly dental visits
Fillings for insured family members
However, some dental plans may provide additional coverage for root canal therapy, crowns, and gum disease treatment for higher premiums.
There are various dental insurance coverage plans available. For example, full coverage dental insurance includes:
Basic care: teeth polishing, check-ups, and X-rays.
Dental treatment: all kinds of treatments, ranging from fillings and root canals to dentures and crowns.
Orthodontic treatment: maintainers, braces, and other teeth straightening devices.
Emergency care: urgent treatment can be covered in full coverage plans.
Dental injuries: may be covered under a full coverage insurance plan.
Oral cancer services: may be covered by some plans.
A dental insurance plan is based on the insurance providers (dentists) you choose. The provider will most likely be one that:
You are able to visit
You are familiar with
You can afford to pay
If you already have a dentist you visit regularly and they are in the insurance provider's network, you will be able to choose one of the less expensive plans.
If you do not have a regular dentist, but begin visiting one in the insurance provider's network, you will also be able to choose one of the less expensive plans.
However, if the dentist is not within the insurance provider's network, then you will need a more costly dental insurance plan for the out-of-network provider.
Terms You Should Know
Death Benefit: The amount of money that will be paid out to a policyholder’s beneficiaries when they die.
Premium: A regular payment made to a life insurance company in exchange for life insurance coverage.
Policyholder: The person who is insured by a life insurance contract.
Life Insurance Beneficiary: A nominated person who will receive a portion of the full insurance contract’s death benefit.
How Much Does Dental Insurance Cost?
The cost of dental insurance will depend on:
The insurance provider.
The plan you choose.
However, the average premium for a basic dental plan ranges between $20 and $60 per month.
If you are paying a $50 premium for your dental insurance, you will have to pay the $600 on dental costs each year even if you don’t have any dental work done that year.
Cosmetic dental procedures, such as veneers and teeth whitening, are generally not covered by dental insurance since they are not considered medically necessary.
Rates vary depending on your location and other circumstances, so you should get a customized quote to understand how much dental insurance will cost you.
How Much Do Dental Services Cost without Insurance?
Without a dental insurance plan covering your dental expenses, procedures can become pricey.
According to Forbes Advisor, here are some of the average costs of dental services without dental insurance:
|Preventive Services||Basic Services||Major Services|
|Basic cleaning and polish: $75–$200||Fillings: $50–$250||Bridge: $1,550–$2,500|
|Dental x-rays: $100–$200||Tooth extraction: $75–800||Crowns: $500–$2,000|
|Root canal: $600–$1,400 (Teeth in the back are more expensive than front teeth)||Dentures: $770–$2,200|
|Implants: $1,500–$2,000 per implant|
There are additional costs for a crown, tooth and root extractions, office visits, and pre-or post-op care.
These additional charges can range between $1500 and $2800, bringing the total cost without dental insurance for a single implant procedure to over $4,000.
The ranges for each of these procedures depend on the size of the bridge, tooth, cavity, the materials used, and the complexity of the procedure.
What Does Dental Insurance Not Cover?
Most dental insurance policies have what is called annual maximums. These are the maximum amounts that the insurance company will pay for dental coverage each year.
Some dental insurance plans have low annual maximums of around $1,000.
Once your dental bills exceed $1,000, you will be responsible for paying any of the remaining costs. The insurer will not pay for any procedure that costs more than $1,000.
Different insurance providers have various maximums for their dental plans. If you are in need of basic dental work, such as a filling, then your premium should cover the costs.
However, if you end up reaching your premium coverage but still need dental coverage for a larger procedure, such as crowns, then you may end up having to pay $500 to $2,000 out-of-pocket, plus your annual $600 in premiums as mentioned earlier.
Expensive procedures, such as orthodontics and cosmetic dentistry, are also rarely covered by dental insurance.
Even if your insurance covers them, the annual maximums frequently prevent you from saving much, if anything, when you account for routine procedures like biannual cleanings and checkups.
What Is Cosmetic Dentistry?
Any dental work that improves the appearance of teeth, gums, and/or bite is referred to as cosmetic dentistry.
Cosmetic dentistry generally focuses on improving the color, position, shape, size, alignment, and overall appearance of the teeth.
Take Note of the Dental Insurance Waiting Period
Most dental insurance plans have a waiting period during which major procedures are not covered for a year after the plan begins, with minor ones not covered for three months.
Different Types of Dental Insurance
These are the three main types of Individual dental insurance plans:
|Dental Health Maintenance Organization (DHMO)||Dental Preferred Provider Organization (DPPO)||Dental Indemnity Insurance|
|Monthly premiums||Lowes premium payments||Medium premium payments||Highest premium payments|
|Cap||No annual cap||Annual maximum cap||Annual maximum cap|
|In-network dentists||Must use in-network dentists||In-network dentists preferred||Wide range of dentists to choose from|
|Out-of-network dentists||Not allowed to use out-of-network dentists||May use out-of-network dentists, but at a higher fee||May use out-of-network dentists, but at a higher fee|
|Additional||May pay a higher % of dental care costs than a DHMO||Small deductible, if any|
How do you know which one is right for you? In most cases, you’ll go with whatever type of plan your employer or work offers.
However, if you have a choice or you are buying your own insurance, talk to your dentist and see what plans their practice accepts and recommends.
On the other hand, if you don’t have a dentist, or don’t mind going to a new dentist, shop for a plan that offers the coverage that you need, at a price that you can afford.
Alternatives to Individual Dental Insurance
There are many alternatives to dental insurance. Two of these options are employee-supplied insurance and dental savings plans.
An alternative to an individual dental insurance plan is to get dental insurance through your employer.
Typically, dental insurance forms part of employers’ group life insurance, which covers employees or members of an organization's health insurance. It may also offer additional benefits, such as hearing, vision, health care, and prescription drugs.
These employer-sponsored plans are typically cheaper than buying individual life insurance and may also offer better benefits.
If you get your dental insurance from your company, it is important to check the monthly premiums, annual maximums, and coinsurance amounts.
Your employer may be able to offer you a great plan with a $20 premium that covers your whole family, or they could offer a plan that costs $50 a month with a low annual maximum.
In the first example, you and your family could benefit from the employer-sponsored plan, but with the second, you may be better off finding individual insurance that is a better fit for you.
Dental Savings Plan
Another option is to sign up for a dental savings plan. Dental savings plans, also known as dental discount plans, are designed for individuals, families, and groups looking to save money on their dental care needs.
Members of dental savings plans can save between 10-60% on the typical costs of dental care and treatments and choose from a nationwide network of over 100,000 dentists.
Dental care providers who offer such plans have agreed to accept a lower fee from plan members. To get most dental services at a discount, you only need to show your membership card when you visit a dentist who is part of your plan. You pay the discounted rate directly to the dentist.
Is Dental Insurance Worth It?
Dental insurance is not like most other types of insurance. The risk of not having health insurance or home insurance, for example, is so significant that hardly anyone can afford to be uninsured. The risk of not having dental insurance is low.
If you require only preventative care, such as routine cleanings, exams, and X-rays, having dental insurance could cost you more money than if you were to pay out-of-pocket.
For example, if you paid for these treatments out-of-pocket, you might spend roughly $400 per year, whereas your insurance premiums might cost $600 per year.
Older adults, or individuals needing more major dental procedures, may find dental insurance worth it.
Most major procedures, such as crowns, root canals, dentures, and tooth replacements are sometimes too costly to pay out of pocket.
If you need these major procedures or are concerned you may in the future, then dental insurance and its coverage could be worthwhile.
If you cannot afford dental insurance, then observing good dental hygiene may be the best way to avoid potential out-of-pocket costs.
Brushing and flossing on a regular basis, switching to a low-cost electric toothbrush, getting professional cleanings every six months, and visiting a dentist who performs high-quality work that lasts for years can all help you save money in the long term.
Where Can I Learn More about Health Insurance?
Dental care can be a very important factor in someone's life, especially if a certain circumstance requires it or when facing a medical emergency. For example, if an individual needs dentures or a crown to relieve pain or discomfort.
However, depending on your needs, having dental insurance may not be worth it as you may save money by covering your dental costs out-of-pocket.
If you are wanting to find out more about dental and other health insurance options or have some unanswered questions, get in touch with one of our professional consultants for personal and detailed advice. Send us an email at firstname.lastname@example.org or give us a call at 1-888-912-2132.
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